Background: The Nottingham Health Profile (NHP) is a well-known quality of life questionnaire. However, wheelchair-bound patients might obtain misleading scores on the scales Physical mobility, Pain and Emotional reactions. We tested three possible adaptations of the Dutch NHP to overcome this problem.
Methods: Respondents were 111 wheelchair-using people (walking ability maximum 5 m) with spinal cord injury, rheumatic diseases and other diagnoses. Adaptation methods were formulation of new questions (Q-NHP), a recoding procedure (R-NHP) and deleting items (D-NHP). Internal consistency, correlations between original and adapted scales and correlations with upper and lower extremity function and social functioning (NHP part II) were computed.
Results: All adapted Pain and Emotional reactions scales were close to the original ones. The original Physical mobility scale proved invalid, resulting in better median scores for those patients who could not walk at all (38.7) than for patients who could walk a bit (50.0). The Q-NHP performed little better than the original one and suffered from greater complexity. The R-NHP showed better internal consistency (0.69 versus 0.49) and construct validity than the D-NHP.
Conclusion: An uncomplicated recoding procedure, scoring five questions about walking problems as ‘yes’ if respondents confirmed the question ‘I cannot walk at all’, improved reliability and validity of the Dutch NHP. Use of this recoding procedure in future research using the NHP is recommended, although its applicability in other language versions has to be proven in future research.
Get full access to this article
View all access options for this article.
References
1.
Hunt SM, McEwen J. The development of a subjective health indicator. Sociol Health Illness1980; 2: 231–246.
2.
Wilkin D, Hallam L, Dogget MA. Measures of need and outcome for primary health care. Oxford: Oxford University Press, 1992.
3.
McEwen J, McKenna SP. Nottingham Health Profile. In: Spilker B ed. Quality of life and pharmacoeconomics in clinical trials, second edition. Philadelphia: Lippincott-Raven, 1996.
4.
Wielink G, Essink-Bot ML, Kerrebroek PE, Rutten FF. Sacral rhizotomies and electrical bladder stimulation in spinal cord injury. 2: Cost-effectiveness and quality of life analysis. Eur Urol1997; 31: 441–446.
5.
Kersten P, Mullee MA, Smith JAE, McLellan L, George S. Generic health status measures are unsuitable for measuring health status in severely disabled people. Clin Rehabil1999; 13: 219–228.
6.
Pluym SMF, Keur TJA, Post MWM, Gerritsen J. Community integration of wheelchair-bound athletes: A comparison before and after onset of disability. Clin Rehabil1997; 11: 227–235.
7.
Leusen NDM van, Gerritsen J, Post MWM. Korte termijn veranderingen in gezondheidstoestand na klinische revalidatiebehandeling: Pilot onderzoek bij dwarslaesiepatiënten (Short-term changes in health status after discharge from the rehabilitation centre: Pilot study in patients with spinal cord injuries). Paper presented at the annual conference of the Dutch Council for Rehabilitation Medicine, Amsterdam, April 1997.
8.
Paping MA, Ter Steeg AM, Gerritsen J, Post MWM. Gezondheidstoestand en welbevinden van mensen met rheumatische aandoeningen (Health status and well-being in wheelchair bound patients with rheumatic diseases). Paper presented at the annual conference of the Dutch Council for Rehabilitation Medicine. Enschede, October 1998.
9.
Erdman RAM, Passchier J, Kooijman M, Stronks DL. The Dutch version of the Nottingham Health Profile: Investigation of psychometric aspects. Psychol Rep1993; 72: 1027–1035.
10.
Erdman RAM, Passchier J. Nottingham Health Profile: handleiding voor de geautoriseerde Nederlandse versie (Nottingham Health Profile: manual for the authorized Dutch version). Rotterdam: Instituut Medische Psychologie-Psychotherapie, 1994.
11.
Nunnally JC. Psychometric theory. New York: McGraw, 1967.
12.
Cohen J. Statistical power analyses for the behavioral sciences, second edition. New York: Academic Press, 1988.
13.
Post MWM, Gerritsen J, Dijk AJ van, Asbeck FWA van, Schrijvers AJP. SIP68 of RAND36: Een vergelijking bij dwarslaesiepatiënten van twee generieke vragenlijsten voor het meten van de gezondheidstoestand (SIP68 or RAND36: A comparison of two generic health status questionnaires in patients with spinal cord injuries). Tijdschr Soc Gezondheidsz1996; 74: 204–212.
14.
Post MWM, Bruin AF de, Witte LP de, Schrijvers AJP. The SIP68: a measure of health-related functional status in rehabilitation medicine. Arch Phys Med Rehabil1996; 77: 440–445.
15.
Bruin AF de, Diederiks JPM, Witte LP de, Stevens FCJ. SIP68: A short generic version of the Sickness Impact Profile. Maastricht: Dept. of Medical Sociology, Maastricht University, 1994.
16.
Spilker B ed. Quality of life and pharmacoeconomics in clinical trials, second edition. Philadelphia: Lippincott-Raven, 1996.
